The use of an endoscope for examining a body cavity is well known in the art. The diagnostic and therapeutic advantages conferred by direct examination of the gastrointestinal tract with a flexible endoscope have made this method a standard procedure of modern medicine. One of the most common endoscopic procedures is colonoscopy, which is performed for a wide variety of purposes, including diagnosis of cancer, determination of the source of gastrointestinal bleeding, viewing a site affected by inflammatory bowel disease, removing polyps, and reducing volvulus and intussusception.
While colonoscopy is useful and effective, it is a difficult procedure for a physician to perform and is painful and occasionally dangerous for the patient. These problems stem from the need to push and steer the long, flexible colonoscope through the intestine by pushing it in from its proximal end, outside the body.
It would be desirable to provide a propulsion mechanism to push or pull the endoscope forward from its distal end, inside the body. A number of methods and devices have been proposed for this purpose, although none has achieved clinical or commercial acceptance.
U.S. Pat. No. 4,207,872 to Meiri et al., whose disclosure is incorporated herein by reference, describes a device and method for advancing an endoscope through a body passage utilizing multiple fluid-filled flexible protrusions distributed along an outer surface of a sleeve containing the endoscope. Alternately increasing and decreasing the fluid pressure within the protrusions advances the endoscope along a body passage. Each protrusion is in direct contact with an inner surface of the body passage and applies local contact pressure against this relatively small contact surface in order to propel the endoscope forward.
U.S. Pat. No. 3,895,637 to Choy, whose disclosure is incorporated herein by reference, describes a device able to move through a tubular organ by sequentially inflating and deflating first and second radially inflatable members. The inflation anchors the inflated member against a local region of the tubular organ, while air pressure in a longitudinally inflatable communicating part of the device moves the non-anchored part of the device longitudinally through the tubular organ. Sufficient contact pressure of the inflated member against a relatively small length of the tubular organ is required in order for the device to be able to progress through the organ. U.S. Pat. No. 3,895,637 has no provision to distribute the contact pressure over a larger area of the tissue against which it presses in order to generate longitudinal motion.
U.S. Pat. No. 4,321,915 to Leighton et al., whose disclosure is incorporated herein by reference, describes an everting tube device for introducing a tool into a body cavity using alternating steps of applying positive pressure to evert the tube and advance the tool, and applying a vacuum to pull the everted tube away from the tool so that an operator can retract the tool one half of the distance it advanced in the previous step. The operator using this device is required to manually withdraw the tool the prescribed distance during every pressure cycle in order to avoid causing the tool to advance too far beyond the tip of the everted tube.
U.S. Pat. No. 4,403,985 to Boretos, whose disclosure is incorporated herein by reference, describes a jet-propelled device for insertion into body passageways. Pressurized fluid is passed to the device from outside of the body and then ejected from an orifice in the device in one direction in order to propel the device in the opposite direction. The device of U.S. Pat. No. 4,403,985 thus generates propulsion by expelling material into the body passageway.
PCT patent application PCT/IL97/00077, to Lerner, whose disclosure is incorporated herein by reference, describes an endoscopic insertion device in the form of a flexible tubular semi-toroidal sheath. An endoscopic probe is inserted into the sheath, and the sheath is inserted into a lumen. Pushing on the probe causes the sheath and the probe to move into the lumen, by the sheath moving in the same way as the tracks of a tracked vehicle.